Answer MI 4

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Previous ECG: MI 3 | Next ECG: MI 5

Where is this myocardial infarction located?

ECG MI 4


Answer

Culprit lesion: RCA

  1. sinus bradycardia
  2. about 55/min
  3. normal conduction
  4. intermediate (normal) axis
  5. normal p wave morphology
  6. tall R in V2, otherwise normal QRS morphology
  7. ST elevation in II, III, AVF (in III > II). Depression in I, AVL, V2.
  • Conclusion: Inferoposterior MI caused by a RCA occlusion

Arguments in favor of RCA occlusion (instead of RCX):

  • ST depression in I, AVL
  • bradycardia
  • ST elevation in III > II ('the highest ST elevation points at the culprit lesion')